Internet of Everything

The future of stroke patients is largely determined by how much and what kind of physical activity they get after they leave the hospital, say doctors. But objective information about patients’ real-life exercise patterns is tough to nail down. Bruce Dobkin, professor of neurology and director of the UCLA Neurologic Rehabilitation and Research Program, is trying to solve that problem with networked sensors that patients wear on their ankles. The sensors record the accelerations and decelerations as the person moves. A smart phone sends the data to computer programs that analyze the type, quantity and quality of the movements. Walking speed and distance, asymmetries in leg movements, and diligence in practicing particular skills can be recorded.

Twice a week, patients get a phone call. Based on the data, the patients get feedback on their activities and advice on how they might improve daily exercise, says Dobkin.

Traditionally, stroke patients see a doctor a month after being released, and then two or three months after that. “If the patient isn’t active between these doctor visits, that crucial recovery time has been wasted,” Dobkin says. He and other researchers are now examining whether the data collection and feedback increase daily exercise, improve walking and reduce risk factors for repeated stroke or heart attack. “Sensors like this could significantly reduce disability from stroke and prevent subsequent strokes,” he says.

Listening to Digestion

AbStats are a pair of disposable, one-inch sensor/microphones that people wear on the abdomen to record the sounds of the digestive tract. A computer at the patient’s bedside analyzes the information to tell doctors when and how the person should eat, says Brennan Spiegel M.S. ’04, professor at the David Geffen School of Medicine at UCLA. Initially, it will be used on surgery patients: Because surgery shuts down the digestive system, doctors have had to guess when a digestive tract is ready to accept food again.

“Working intestines make sounds as they contract, which we can now measure. That information tells us when the patient is ready to eat full meals and can be released from the hospital,” says Spiegel, who is also an adjunct professor in the UCLA Fielding School of Public Health.

Spiegel’s research has been licensed by start-up GI Logic. Eventually, says Spiegel, disposable and inexpensive wireless AbStats sensors and a simplified app could be used to monitor the millions of people with irritable bowel syndrome and allergies to gluten, lactose and other food substances. “We have invented a new vital sign — your intestinal rate, a measure of how quickly your intestines are moving,” he says.

Spiegel anticipates the FDA approving AbStats for use in hospitals by early 2015, and for consumer use by early 2016.

A Cane with Brains

Consider the lowly walking stick, a candidate for a digital upgrade if ever there was one. Motion-sensing research by the UCLA Wireless Health Institute is being licensed for a new kind of ergonomic cane that senses users’ walking patterns and even predicts when they might fall. The Isowalk cane is outfitted with wireless motion sensors that send data about the user’s gait to smart phones, tablets or desktop computers. The data is fed into the user’s profile and analyzed to reveal changes or aberrations that could mean trouble.

“It can be useful for helping elders who have trouble walking, or for patients recovering from an injury or orthopedic surgery,” says Ron Goldberg, founder/CEO of Isowalk. Goldberg is lining up funding and expects to start selling the smart cane to consumers for about $179 by late 2015. Isowalk and UCLA WHI will pursue FDA approval, which would allow the device to be deployed in clinical settings and prescribed in a rehabilitation regimen. “Everyone heals differently,” says Goldberg. “This device quantifies how patients are actually doing, how well and how often they are walking. It makes their care more efficient.”

Losing Control?

While individual devices are fascinating, the real heart of the “Internet of Everything” is having objects connect with each other and invisibly respond to our behavior, which is also when our privacy is most vulnerable. When our smart objects share our information, we will probably lose control of where that info is going, says Leah Lievrouw, UCLA information studies professor and a member of UCLA’s Advisory Board on Privacy and Data Protection. Banks, employers, insurance companies and marketers are all interested in details about our lives, and “when computerized objects are networked, the product is no longer our health, energy use or banking. The product is the data,” Lievrouw warns.

Nonetheless, the technology of computerized things is proceeding at a lightning pace. If we are smart enough to manage the privacy and complexity issues, experts say the only constraint will be our imagination.